+AA
Fr
McMasterLogo_New-2017-300x165
Back
Clinician Article

Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies.



  • Pocock SJ
  • Ariti CA
  • McMurray JJ
  • Maggioni A
  • Kober L
  • Squire IB, et al.
Eur Heart J. 2013 May;34(19):1404-13. doi: 10.1093/eurheartj/ehs337. Epub 2012 Oct 24. (Original)
PMID: 23095984
Read abstract Read evidence summary Read full text
Disciplines
  • Internal Medicine
    Relevance - 6/7
    Newsworthiness - 6/7
  • Cardiology
    Relevance - 5/7
    Newsworthiness - 5/7

Abstract

AIMS: Using a large international database from multiple cohort studies, the aim is to create a generalizable easily used risk score for mortality in patients with heart failure (HF).

METHODS AND RESULTS: The MAGGIC meta-analysis includes individual data on 39 372 patients with HF, both reduced and preserved left-ventricular ejection fraction (EF), from 30 cohort studies, six of which were clinical trials. 40.2% of patients died during a median follow-up of 2.5 years. Using multivariable piecewise Poisson regression methods with stepwise variable selection, a final model included 13 highly significant independent predictors of mortality in the following order of predictive strength: age, lower EF, NYHA class, serum creatinine, diabetes, not prescribed beta-blocker, lower systolic BP, lower body mass, time since diagnosis, current smoker, chronic obstructive pulmonary disease, male gender, and not prescribed ACE-inhibitor or angiotensin-receptor blockers. In preserved EF, age was more predictive and systolic BP was less predictive of mortality than in reduced EF. Conversion into an easy-to-use integer risk score identified a very marked gradient in risk, with 3-year mortality rates of 10 and 70% in the bottom quintile and top decile of risk, respectively.

CONCLUSION: In patients with HF of both reduced and preserved EF, the influences of readily available predictors of mortality can be quantified in an integer score accessible by an easy-to-use website www.heartfailurerisk.org. The score has the potential for widespread implementation in a clinical setting.


Clinical Comments

Cardiology

Interesting compliation of CHF risks.

Internal Medicine

Useful information. I found the list of determinants and their order of importance valuable. Having to go to a website and input data would be an impediment to practical use right now.

Register for free access to all Professional content

Register
Want the latest in aging research? Sign up for our email alerts.
Subscribe

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use